Provider Demographics
NPI:1780160325
Name:HILL, DANA REILLY (OD)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:REILLY
Last Name:HILL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:JANINA
Other - Last Name:REILLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3155 N UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-8703
Mailing Address - Country:US
Mailing Address - Phone:719-630-3937
Mailing Address - Fax:
Practice Address - Street 1:3155 N UNION BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8703
Practice Address - Country:US
Practice Address - Phone:719-630-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0003416152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist